Therapeutic leg and foot device

ABSTRACT

A therapeutic leg and foot device comprising an L-shaped member having an elongated channel-like portion adapted to fit the posterior region of the lower leg and a foot portion extending integrally at right angles therefrom. The integral connection is curved to avoid contact with the patient&#39;s heel when the device is in place. The channel shape flattens out at the curved portion and is narrowed to promote the required flexing at this point. The device is constructed of resilient transparent acrylic plastic material which is resilient under a stress load but has sufficient rigidity to maintain a bed patient&#39;s foot in properly disposed position to prevent bed sores or drop foot. However, when used in the correction of drop foot, the foot portion is flexed away from the perpendicular to an obtuse angle with the leg portion to conform to the deformity. In this position the device exerts a 30 to 50 lb. pressure on the foot area to bias the foot back into normal position. There is also an equal amount of pressure or counter force on the lateral arch to correct outward turning of a foot usually associated with a foot drop deformity. This rigid flexibility also permits its use as an ambulation aid in gait training. The device is provided with releasable means for securing to the patient&#39;s foot. Attachments may be made for preventing undesirable rotation of the leg; for making the device rigid to maintain the immobility of the foot and heel; and for maintaining the bed sheets and blankets in spaced relation to the patient&#39;s toes.

BACKGROUND OF THE INVENTION

This application is a substitute for my application Ser. No. 399,365,filed 9/21/73, which was a continuation in part, all under the sametitle, of a co-pending application Ser. No. 237,643, filed Mar. 24,1972, now both abandoned and entitled THERAPEUTIC LEG AND FOOT DEVICE.

Therapeutic devices for preventing drop foot, maintaining the patient'sfoot in proper position, and for acting as a heel guard are well knownin the art. For example, U.S. Pat. No. 3,345,654 illustrates a typicalconstruction of such a device.

However, these devices are merely splints and are not primarily designedto correct an existing condition. They are not designed to apply acorrective pressure to the foot. As a matter of fact, their rigidityprecludes their use to correct an existing condition.

Furthermore, they are not designed to act as a walking brace orambulation aid in gait training. This is important where the patient hasbeen bed ridden for an extended period. This is especially true wherethe foot and leg have been held rigid.

SUMMARY OF THE INVENTION

The device of the present invention is truly therapeutic device and nota mere leg brace or splint. It is designed to provide a steady andaccurately placed pressure on the sole and calf to correct existingdeformities of the foot. Provision is made for augmenting the pressure,if necessary. When in place, the device can be worn inside of the shoeand act as an ambulation aid. This it does by applying an activecorrective pressure under normal walking conditions and flexing with themovement of the toes and heel as in natural walking. All this while thepressure is applied to the first, third, fourth and fifth metatarsalbones and arch, to bring the foot automatically upward.

The device is also highly versatile. It can be made rigid by theaddition of an easily mounted attachment for the purpose of holding thefoot or heel in a rigid position. Another attachment will preventrotation of the patient's foot, leg or hip. This may be necessary in apost operative condition.

A further attachment keeps sheets and blankets away from the patient'stoes and foot while lying in bed. And finally, the device is made toreceive any other suitable attachment such as a spreader for retainingthe legs in spread position.

It should be noted that in the case of medical or surgical work on theheel and adjacent areas, the device will retain the foot in fixedposition while maintaining a spaced relation with the heel. This permitslight bandaging, makes it easily accessible to the doctor forexamination, and eliminates the need for immobilizing heavy bandages orcasts.

DESCRIPTION OF THE DRAWINGS

In the drawings;

FIG. 1 is a side elevation of the device of the present inventionshowing its flexing position and dynamic return;

FIG. 2 is a longitudinal section thereof;

FIG. 3 is an end view showing the area for the proper application ofcorrective pressure;

FIG. 4 is a section taken on line 4--4 on FIG. 1;

FIG. 5 is a section taken on line 5--5 on FIG. 1;

FIG. 6 is a section taken on line 6--6 on FIG. 1;

FIG. 7 is a section taken on line 7--7 on FIG. 1;

FIG. 8 is a view similar to FIG. 1 with the device mounted on a patientin a prone position;

FIG. 9 is an end view similar to FIG. 3 with the device mounted as shownin FIG. 8;

FIG. 10 is a view similar to FIG. 8 showing the mounting of severalattachments;

FIG. 11 is a perspective view of the attachment for maintaining the bedsheet and blanket spaced from the toes;

FIG. 12 is a front view of the attachment for preventing rotation;

FIG. 13 is a bottom view of the attachment shown in FIG. 12, partiallybroken away;

FIG. 14 is a view similar to FIGS. 8 and 10 showing the addition ofstill another attachment;

FIG. 15 is a perspective view of the spreading attachment; and

FIG. 16 is a side elevation illustrating the use of the device as anambulation aid in an existing contracture deformity.

DESCRIPTION OF THE INVENTION

Referring to the drawings in more detail, the device of the presentinvention is more clearly illustrated in FIGS. 1 to 7, inclusive. Thedevice is molded of an acrylic transparent thermo-plastic material in ageneral L-shape, forming a leg portion 20 and a foot portion 21extending integrally from a curved heel section 22 at right angles tothe leg portion 20.

The leg portion 20 is contoured and channeled, as shown in FIGS. 1, 3, 6and 7, so as to comfortably receive the posterior region of the lowerleg. It is specifically depressed just above the ankle bone, see FIG. 8,and below the greater calf to act as a support and receive most of theweight concentration. This is the area that supplies the counter-forcefor the flexing pressure of the foot portion 21 as hereinafterdescribed. The portion 20 is provided at this point with a central stud23 and a pair of spaced keyhole slots 24 adjacent the stud 23 toward theheel end.

The foot portion 21 is also contoured and channeled but to a lesserdegree, see FIGS. 1, 2 and 4. The length of the portion 21 is such thatits upper end terminates well short of the patient's toes when worn asin FIGS. 8 and 9. The device is flexible, and when the foot portion 21is pulled into the dotted line position shown in FIG. 1, it will applypressure to the bottom of the heel, the lateral arch, and the transversemetatarsal bones and arch as shown in the broken line area 25 in FIG. 2.The central portion of the foot portion 21 is also provided with a pairof keyhole slots 26, see FIGS. 2 and 9.

To permit a proper flexing action, the heel portion 22 is provided withan area of the least amount of contouring and channeling, being almostflat, see FIGS. 3 and 5. The curvature is such that not only is there nopressure applied to the rear of the patient's heel, but there is anactual space 27 between the patient's heel and the heel portion 22 whenthe device is in place as in FIGS. 8 and 9.

Since the most important function of the device is its ability to flexat 22 to apply the proper therapeutic pressure, the material andconstruction at this point is of prime importance. First of all,rigidity along the portion 20 is supplied in part by its channel shape.This channeling gradually disappears as the heel portion 22 is reached.FIG. 7 shows the largest and deepest channeling, FIG. 6 is smaller, andFIG. 5, closest to the portion 22, shows it virtually gone. At the point22, the device should be substantially (possibly not completely) flat.Furthermore, as can be seen in FIGS. 5, 6 and 7, the device is narrowestat this point. the degree of flexibility can thus be controlled by thedegree of channeling and the narrowing of the material at the heel.

Since flexibility is essential, the material is also important. Thedevice is made of an acrylic thermo-plastic material approximately 0.125inch in thickness. In small sizes for children, it may be only 0.087inch thick. The leg portion 20 is approximately 10 inches long and thefoot portion 21 is approximately 6 inches long. The heel portion 22 isapproximately 11/2 inches across. To complete the construction, the legportion 20 is approximately 4 inches at its maximum width, the footportion 21 3 3/4 inches, and the heel portion 22 only 2 inches wide.

With the above construction, the device will apply a pressure of 30 to50 lbs. when flexed. Applicant has found that the acrylic plastic hasthe required characteristics. However, the constant flexing and useunder stress loads requires fatigue strength, longevity, and resiliencyunder the stress loads over long periods of time. The acrylic fillingthese requirements is called "Nyloplex" and is sold by Fillauer SurgicalSupplies of Chattanooga, Tenn. A product called "Lexan" manufactured byGeneral Electric Cimpany is also satisfactory but slightly more sluggishin its flexing reaction. As with most acrylics, the above products havea "memory" so that they return to their original right angled form aftereach flexing.

The device is light in weight, approximately 6 oz., but the flexibleacrylic has a tensile strength to withstand up to 250 lbs. of continuousresistance without fracturing, losing shape, or distorting. When flexedinto the dotted line position shown in FIG. 1, it will exert a force of30 to 50 lbs. pressure to the area shown by the arrows 28 in FIG. 8. Thepressure is applied against the counter-pressure at the calf shown bythe arrows 29.

This is the action necessary to correct a foot deformity such as dropfoot. The patient's foot is placed into the device by flexing the footportion 21 to an angle, FIG. 1, which will permit the insertion of thefoot, then the portion 21 is released to apply the pressure. Anysuitable means may be used to secure the device to the leg and foot ofthe patient. For example, viewing FIGS. 8 and 9, I use a soft leathersleeve or sandal 30 which is slipped over the patient's foot and thefoot portion 21 of the device. It is provided with a cut out heelportion with strips 31 and 32 passing under the foot and strips 33behind the upper heel. The front is provided with a flap 34 having anysuitable fastening means such as the Velcro fastener 35, for securementaround the instep. An additional strip 36, provided with a Velcrofastener 37, extends above the ankle region. In addition to the sandal30, the leg portion 20 is provided with slots 38 adjacent the rear upperend. A strip 39 extends around the leg through the slots 38 to competethe mounting of the device.

With the device worn as shown in FIGS. 8 and 9, the application of thepressure as illustrated by the flexing action in FIG. 1 and the arrows28 in FIG. 8 will correct any drop foot or similar deformity and willcertainly prevent the formation thereof. Furthermore, the counter forcepressure on the lateral arch will correct any outward turning of thefoot usually associated with a foot drop deformity. The device iscomfortable and will be tolerated by the patient over extended periodsof time. It eliminates the need for weighted bags, foot boards, pillows,heavy dressings, and many other ineffective methods of treatment. Notethat the device is always in place, whereas the other methods are hit ormiss depending on the position of the patient. The device willaccommodate either the right or left foot, male or female, and may bereused on another patient.

The device is also designed to be used in the prevention of heeldecubitus and aid in the heeling of an existing one. Since the heel issuspended at 27 it clears the tender area and there is no contact orpressure. The transparency of the device allows the involved area to beconstantly observed. In surgery, the device holds the foot rigid andallows the use of a light bandage for frequent observation by the doctorduring healing.

When the device is in use, it may also be found necessary to keep thesheets and blankets off the patient's toes. To this end I provide theattachment shown in FIGS. 10 and 11. An elongated strap-like member 40is curved to conform to the contour of the foot portion 21. It isprovided with a pair of studs 41 adjacent the lower end. The member 40is slipped under the strip portion 31 of the member 30, the studs 41locking in the slots 26. The member 40 thus extends above the toes andkeeps the sheets and blankets at a distance.

It is often desirable to provide means for preventing rotation of thepatient's leg for hip or leg conditionsa and for providing immobilityafter operations in these areas. This is accomplished by the attachmentshown in FIGS. 10, 12 and 13. An elongated plastic member 42 is providedwith a flat bottom and enlarged ends 43. The center is provided with acradle portion 44 adapted to receive the leg and leg portion 20 (brokenlines in FIG. 12). The leg portion 20 is locked to the member 42 byproviding the cradle portion 44 with a central keyhole slot 45 forreceiving the stud 23. For additional immobility, the parts may beprovided at each side with snap fasteners 45a on the cradle portion 44and leg portion 20. As can be seen in FIGS. 10 and 12, the attachment 42prevents rotation of the patient's leg in the device. Note that thisattachment can be used simultaneously with the attachment 40 as shown inFIG. 10.

While the construction is designed to provide a flexing pressure of 30to 50 lbs., in certain extreme conditions it may be desirable toincrease the pressure by an additional 20 to 25 lbs. In such cases theattachment shown in FIG. 14 may be used. This comprises an L-shapedstrip 46 of the same flexible acrylic material as the device itself. Itis shaped to the outer contour of the device, having a leg portion 47,heel 48, and a foot portion 49. The foot portion 49 extends upwardlybeyond the toes to perform the function of the attachment 40 to spacethe sheets and blankets from the toes. The strip 46 is provided with akeyhole slot for receiving the stud 23 of the leg portion 20 and isprovided with studs 50 for attachment to the keyhole slots 26 in thefoot portion 21. In the mounted position shown in FIG. 14, the strip 46adds 20 to 25 lbs. to the flexed pressure of the foot portion 21.

In certain surgical applications it may become necessary to retain thefoot in a rigid, immovable position such as shown in FIG. 14. In suchcases, the attachment 46 is made of a rigid material such as a metal orrigid plastic without flexibility. Its construction and method ofmounting would be the same as the member 46, but it would hold the footrigidly by counteracting the flexibility of the main device.

Another useful attachment for the device is the spreader 51 shown inFIG. 15. In surgical procedures involving thighs, groin and relatedareas, it may be necessary to keep the patient's legs spread duringhealing. In such cases a device of the present invention is firstmounted on each foot and leg. The spreader 51 comprises a pair of strips52 and 53 adjustably connected at 54. At their outer ends, the strips 52and 53 are provided with studs 55 which can be mounted in the keyholeslots 24 on the leg portions 20 to spread the legs apart. Alternatively,the spreader 51 can be mounted on the foot sections 21 by attaching thestuds 55 to the keyhole slots 26. Either method will result in the samespread position.

As stated hereinabove, one of the advantages of the present invention isits use as an ambulation aid in gait training. As can be seen in FIG.16, the application of pressures at the points 28 and 29 is of primeimportance when walking. Thus the inherent flexibility of the devicewill tend to force the foot into a proper walking action including theflexing of the foot and lifting to move into forward position. Thedevice will apply the same pressure action while walking as it does tocorrect an abnormality in the prone position shown in FIG. 8. It shouldbe noted that the fact that the foot section 21 is short of the toespermits natural movement of the toes and feet while walking. This alsopermits the patient's own shoe to be worn directly over the devicewithout the discomfort. The device thus acts as a walking brace and thepressure on the foot at 28 ensures a proper walking step withoutdragging, regardless of the corrections being made to the foot position.

The present invention therefore provides a therapeutic leg and footdevice of simple construction and designed for its intended purpose.However, the device is extremely versatile in use. It can be used in aprone or in an ambulating position, and it can be used with itsattachments to alleviate, correct, or prevent various conditions.

Other advantages of the present invention will be readily apparent to aperson skilled in the art.

I claim:
 1. A therapeutic leg and foot device comprising an L-shapedmember of a flexible, transparent, acrylic, plastic, said member havinga generally contoured and channel-shaped leg portion, a curved heelportion integral with one end of said leg portion, and a generallycontoured foot portion extending integrally from said heel portion atright angles to said leg portion, said foot portion being shorter thanthe adult human foot, the channel shape of said leg portion beingsubstantially flattened at said heel portion, said curved heel portionbeing narrower than said foot and leg portions and having a free andunflanged edge to permit flexing of said foot portion with respect tosaid leg portion, said foot portion exerting a pressure of 30 to 50 lbs.toward said leg portion when said foot portion is flexed away from theright angle position, and means for releasably securing the device tothe leg and foot of a patient.
 2. A device as in claim 1, wherein saidheel portion is curved away from the patient's heel to provide a spacetherebetween, and wherein the pressure of said foot portion is appliedagainst the heel, lateral arch and transverse metatarsal arch portionsof the foot.
 3. A device as in claim 1, wherein said device is providedwith an attachment for maintaining the bed sheets and blankets in spacedrelation to the patient's toes, said attachment comprising an elongatedstrip of rigid material and means mounting one end of said strip to saidfoot portion, said strip extending upwardly above the patient's toes. 4.A device as in claim 1, wherein said device is provided with anattachment for preventing rotation of the leg, said attachmentcomprising an elongated plastic member having a flat bottom and enlargedends, said member having an arcuate cradle portion for receiving saidleg portion therein, and means immovably releasably locking said legportion in said cradle portion.
 5. A device as in claim 1, wherein saiddevice is provided with an attachment for adding 20 to 25 lbs. flexingpressure to said foot portion, said attachment comprising an L-shapedstrip of flexible acrylic plastic material adapted to extend along theouter surface of said device, and means releasably attaching said stripto said device.
 6. A device as in claim 1, wherein said device isprovided with an attachment for making the device rigid and inflexible,said attachment comprising an L-shaped strip of rigid material adaptedto extend along the outer surface of said device, and means releasablyattaching said strip to said device.
 7. A device as in claim 5, whereinsaid strip is elongated to extend above the toes to keep the sheets andblankets away from the toes.
 8. A device as in claim 6, wherein saidstrip is elongated to extend above the toes to keep the sheets andblankets away from the toes.
 9. A device as in claim 2, wherein saiddevice is provided with an attachment for maintaining the bed sheets andblankets in spaced relation to the patient's toes, said attachmentcomprising an elongated strip of rigid material and means for mountingone end of said strip to said foot portion, said strip extendingupwardly above the patient's toes.
 10. A device as in claim 4, whereinsaid heel portion is curved away from the patient's heel to provide aspace therebetween, and wherein the pressure of said foot portion isapplied against the heel, lateral arch, and transverse metatarsal archportions of the foot.